Quality of youth friendly sexual and reproductive health Services in West Gojjam Zone, north West Ethiopia: with special reference to the application of the Donabedian model

Abstract

Background: Although there has been momentum in implementing sexual and reproductive health services in Ethiopia, young people remain underserved despite their demonstrated needs. Quality care improves utilization of health service and increases the likelihood of obtaining ongoing care. However, little is known about the quality of youth-friendly sexual and reproductive health service in Ethiopia. Therefore, this study sought to investigate the quality of youth-friendly sexual and reproductive health service in West Gojjam Zone, North West Ethiopia. Methods: Health facility-based cross-sectional study was conducted in West Gojjam zone in 2018 to assess the quality of the service using the Donabedian model. The assessment was done through the triangulation of multiple methods: simulated client study; structured interviews with service providers; observations; and key informant interview with providers and expertise. Fifty-four visits were made to 18 randomly selected health facilities by three simulated clients trained to present three different scenarios (i.e., adolescent with sexually transmitted infection, pregnancy test request and a lady with dry cough). Data were entered and analyzed using SPSS version 21. Facility visit score of ≥ 75% in all quality component categorized as "good quality" otherwise classified as performing below the standard. Thematic analysis was done to analyze qualitative data. Results: In this study, none of the health facilities achieved ≥ 75% in the three components of quality measurement. From 18 health facilities, 6(33.3%) provided low quality in all domains. Process component, which measures client-provider interaction and privacy/confidentiality, was the most compromised one. However, a promising result was reported in the input quality that measured the availability of trained providers, drugs, and supplies. The presence of community-based health insurance and age driven comprehensive youth-friendly service delivery approach were identified as challenges to deliver quality services.Conclusions: The quality of the service ranges from low to medium, with adolescent related elements performing poorly. Minor renovations of health facilities, training on client handling, and contextual modifying the age driven youth-friendly service approach may improve the quality of the services.

Primary health care contributions to universal health coverage, Ethiopia

“… 62 In a 2018 study conducted in 32 primary health-care health facilities providing delivery care, the input quality was good in 66% of health facilities; however, the process and output quality was good in only 31% of health facilities. 63 Despite these challenges, there are opportunities. Quality is included in the government’s future plans; 27 the national health-care quality strategy has had promising results; 64 and the use of a community-based collaborative quality improvement initiative has improved postnatal care services in rural Ethiopia.…”

Youth Friendly Reproductive Health Services Among Students of Mizan-Tepi University, South-western Ethiopia

“…Recent ndings from in rural areas indicated that YFRHS provision is limited in a few of government (public) health facilities in urban centres and many youth are less informed, less experienced, and less comfortable in accessing health services in their areas. Moreover, majority of the youth often lack basic YFRHS information and knowledge about the available services, and access to affordable and con dential services [12,13,14,15,11]. Therefore, most of the youths are at a particular risk for unwanted pregnancy and pregnancy related complications [16].…”

Roles and Responsibilities of Expert Clients in Adolescent HIV Service Delivery in Eswatini: A Conventional Content Analysis

“…countries (39)(40)(41). Adolescents in Eswatini are susceptible to gender-based violence, high fertility, and early sexual debut, and yet there are limited SRH and family planning services speci cally for Swazi youth (42).…”